Tapered fused waveguide for delivering treatment electromagnetic radiation toward a target surfaced

ABSTRACT

A radiation emitting apparatus is disclosed that emits a substantially homogenous beam of radiation from an irregularly shaped output end. As described herein, a radiation emitting apparatus includes a bundled fiberguide coupled to an energy distribution tuner. The bundled fiber guide is coupled to the energy distribution tuner to receive a substantially uniform distribution of high power energy. The bundled fiber guide is configured to distribute the energy to emit a substantially uniform distribution of lower power energy toward a target surface, such as a body surface. The bundled fiber guide may include a plurality of fused optic fibers, a plurality of beam splitting mirror elements, or tapered waveguides.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application Ser.No. 60/424,860, filed Nov. 8, 2002, and U.S. Provisional ApplicationSer. No. 60/434,585, filed Dec. 18, 2002, the entire contents of bothwhich are incorporated herein by reference. This application is acontinuation-in-part of U.S. application Ser. No. 10/229,374, filed Aug.26, 2002, now U.S. Pat. No. 6,942,658 the entire contents of which areincorporated herein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates generally to medical devices and, moreparticularly, to laser handpieces.

2. Description of Related Art

Radiation delivery systems are typically used to transportelectromagnetic energy from electromagnetic energy sources to treatmentsites. One common radiation delivery system can comprise acylindrically-shaped fiber optic tip from which electromagnetic energyis emitted in a direction toward the treatment site.

In certain applications, radiation delivery systems can be engineered togenerate predetermined beam shapes and spatial energy distributions. Theenergy distribution of a simple delivery system, comprising a fiberoptic tip, can be described as having a circular illumination area, witha so-called Gaussian distribution of beam intensities being spatiallydistributed within the illumination area. For instance, the illuminationarea from a fiber optic tip can comprise a central high-intensity areaor “hot spot” surrounded by peripheral areas of lower intensity.

Regarding energy distributions, some beam profiling applications canrequire or would be optimized with radiation delivery systems capable ofgenerating illumination areas of relatively uniform density across partsor all of the illumination area. Moreover, it may also be desirable togenerate non-circular illumination areas, or to generate electromagneticradiation having predetermined energy distributions across a non-planarillumination area. Use of laser radiation having a relatively uniformpower distribution over a particularly shaped area can be a practicaltask for multiple medical applications. In seeking to generatepredetermined energy distributions, prior-art systems have implementedrelatively complex optical schemes with multiple optical elements, whichsystems can be relatively large and/or inefficient. A prior-art systemmay comprise, for example, a relatively large length, e.g., about 100 mmto 150 mm, measured from the trunk fiber to the output end of the systemand measured in a direction normal to the target. Regarding efficiency,implementation of a diffuser in front of a prior-art fiber optic endtogether with a mirror reflector may not eliminate the “hot spot”problem and may introduce losses of laser power, which configuration canundesirably result in an efficiency as low as about 50%.

SUMMARY OF THE INVENTION

The present invention provides optical arrangements and relativelycompact medical laser instruments to deliver electromagnetic radiationto treatment sites with relatively uniform power distributions overrelatively wide illumination areas. The illumination areas may compriseplanar surfaces in which case uniform power densities are generatedthroughout a cross-sectional area of the impinging radiation where theradiation intersects the treatment site; or the illumination areas maycomprise non-planar surfaces, such as arched surfaces, in which caseuniform power densities are generated to be relatively evenlydistributed on the non-planer treatment site. The electromagnetic energycan comprise laser radiation, and the treatment site can comprise tissueto be treated.

In accordance with one aspect of the present invention, a radiationemitting apparatus includes a bundled fiberguide coupled to receiveelectromagnetic radiation from an energy distributor, such as anenergy-distribution tuner. The bundled fiberguide can comprise a taperedfiberguide, such as a coherent tapered fused fiber; and theenergy-distribution tuner can comprise a reflector, such as acylindrical reflector, for receiving electromagnetic energy from a fiberoptic, such as a quartz fiber. Electromagnetic energy from theenergy-distribution tuner is coupled to the bundled fiberguide, and thenoutput from the bundled fiberguide at a relatively uniform power densityacross a predetermined treatment site.

The combination of the energy-distribution tuner and the bundledfiberguide operate together to generate radiation having a relativelyuniform power density across an illumination area. The illumination areamay have a substantially planar or non-planar topography.

The various embodiments of the present invention may include or addressone or more of the following objectives. One objective is to provide afiber optic coupled to an energy-distribution tuner, whereinelectromagnetic radiation exiting the energy-distribution tuner is notconcentrated along the fiber optic axis. The energy-distribution tunercan comprise a cylindrical reflector configured to redirect a portion ofthe electromagnetic radiation back toward a direction of the fiber opticaxis. Another objective is to provide a bundled fiberguide having anemission characteristic whereby a power density of electromagneticradiation exiting the bundled fiberguide is lower than a power densityof electromagnetic energy entering the bundled fiberguide. Anotherobjective is to provide a radiation emitting apparatus, which is formedto illuminate the target area with a specific illumination-area shapeand/or distribution required for a particular medical or otherapplication. The shape can be non-circular and the distribution can beuniform as measured on a non-planar surface, which can comprise, forexample, an arched surface. Yet another objective is to provide anapparatus for providing uniform distributions of power density across anillumination area, with optical losses less than 10%, with a minimalnumber of optical components, with a simple construct that is relativelyeasy to make and clean, with reproducible output results, with aconstruct amenable to miniaturization, and/or with relatively reliablecoupling and alignment characteristics. Another objective is to providean apparatus with a relatively short length, measured in a directionnormal to the target.

Any feature or combination of features described herein are includedwithin the scope of the present invention provided that the featuresincluded in any such combination are not mutually inconsistent as willbe apparent from the context, this specification, and the knowledge ofone of ordinary skill in the art. For purposes of summarizing thepresent invention, certain aspects, advantages and novel features of thepresent invention have been described herein. Of course, it is to beunderstood that not necessarily all such aspects, advantages or featureswill be embodied in any particular embodiment of the present invention.Additional advantages and aspects of the present invention are apparentin the following detailed description and claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a radiation emitting apparatus designed for uniformillumination of an arched rectangular surface according to the presentinvention;

FIG. 2 shows a radiation emitting apparatus in accordance with a firstalternative embodiment of the present invention;

FIG. 3 shows a radiation emitting apparatus in accordance with a secondalternative embodiment of the present invention; and

FIG. 4 shows a radiation emitting apparatus in accordance with a thirdalternative embodiment of the present invention.

DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS

Reference will now be made in detail to certain embodiments of theinvention, examples of which are illustrated in the accompanyingdrawings. Wherever possible, the same or similar reference numbers areused in the drawings and the description to refer to the same or likeparts. It should be noted that the drawings are in simplified form andare not to precise scale. In reference to the disclosure herein, forpurposes of convenience and clarity only, directional terms, such as,top, bottom, left, right, up, down, over, above, below, beneath, rear,and front, are used with respect to the accompanying drawings. Suchdirectional terms should not be construed to limit the scope of theinvention in any manner.

Although the disclosure herein refers to certain illustratedembodiments, it is to be understood that these embodiments are presentedby way of example and not by way of limitation. The intent of thefollowing detailed description, although discussing exemplaryembodiments, is to be construed to cover all modifications,alternatives, and equivalents of the embodiments as may fall within thespirit and scope of the invention as defined by the appended claims.

Referring more particularly to the drawings, FIG. 1 shows an exemplaryembodiment of a radiation emitting apparatus 10 comprising a bundledfiberguide 11 coupled to an energy distributor that inputs anelectromagnetic signal with a cross-sectional power distribution andoutputs a signal with a different cross-sectional power distributionthan was input. In the illustrated embodiment, the energy distributorcomprises an energy-distribution tuner 21. In one embodiment, thebundled fiberguide 11 comprises a coherent fused fiberguide thatreceives a given spatial distribution of energy at an input end 13 andemits or outputs a similar or the same relative spatial distribution ofenergy at a different magnification or power density at an output end15.

In one embodiment, the bundled fiberguide 11 can comprise multiplequartz or glass fiber optics fused together. For example, the bundledfiberguide 11 may comprise 1000 quartz or glass fiber optics fusedtogether, or, in another embodiment, may comprise, for example, tentimes that number of fused fiber optics. In an embodiment wherein thebundled fiberguide 11 comprises a coherent tapered fused fiberguide,when a uniform spatial distribution of energy having a relatively highpower density is input into the bundled fiberguide 11, a uniform spatialdistribution of energy having a lower power density is output from thebundled fiberguide 11. Similarly, in the embodiment wherein the bundledfiberguide 11 comprises a coherent tapered fused fiberguide, when agiven spatial distribution of wavelengths is input into the bundledfiberguide 11, the same or about the same spatial distribution ofwavelengths having a greater magnification (or lower power density) isoutput from the bundled fiberguide 11.

The fiberguide 11 is shaped or configured to provide a substantiallyhomogenous beam of electromagnetic radiation from an irregular outputend, such as an irregularly shaped output end. In certain embodiments,the fiberguide 11 is configured to emit energy from a non-circularoutput end having a non-flat or non-planar surface. The apparatusdisclosed herein may thus be easier to manufacture relative to existingapparatus, easier to clean, and/or may result in fewer alignmentproblems. The apparatus may also reduce the number of tolerance issuesto provide more reproducible results relative to existing devices.

As shown in FIG. 1, the fiberguide 11 has a tapered configuration. Inother words, the fiberguide 11 includes an elongate body 30 having aproximal region 32 and a distal region 34. The distal region 34 has across-sectional area that is different than the cross-sectional area ofthe proximal region 32. In the illustrated embodiment, thecross-sectional area of the distal region 34 is greater than thecross-sectional area of the proximal region 32. A non-planar surface,such as surface 14, is provided at the distal end of the elongate body30.

The elongate body 30 may taper in a regular or a non-regular pattern. Inthe illustrated embodiment, the elongate body includes a first portionwith a first cross-sectional area, such as the proximal region 32, asecond portion having a second cross-sectional area that is differentthan the first cross-sectional area, such as distal region 34, and athird portion located between the first portion and the second portion,the third portion having a cross-sectional area having dimensionsbetween the cross-sectional areas of the first and second portions. Oneor more of the portions of the elongate body 30 may include a lengthwhere the cross-sectional area remains substantially constant, or inother words, a portion of the elongate body may not be tapered. Thetransitions from the different portions of the illustrated waveguide 11are curved, which may be helpful to promote effective light reflectancein the waveguide 11. The elongate body 30 is generally formed of amaterial that does not permit appreciable amounts of radiation to beemitted from surfaces other than the surface 14. The elongate body 30may also include a reflective material on an inner surface of the bodyto affect or facilitate the radiation passing through the elongate body.

FIGS. 2, 3 and 4 show alternative embodiments of the bundled fiberguide11 of the radiation emitting apparatus 10. With reference to FIG. 2, thefibers 16 of the fiberguide 11 have about the same diameters throughoutand along their lengths, and are uniformly distributed, or in anotherembodiment approximately uniformly distributed or in another embodimentsomewhat uniformly distributed, in a filling material. In otherembodiments, at least the distal ends but not necessarily the otherportions of the fibers 16, are uniformly distributed or approximatelyuniformly distributed or somewhat uniformly distributed, in the fillingmaterial. The filling material can comprise an opaque or semi-opaqueplastic, and/or can comprise, for example, an opaque or semi-opaquesilicon or epoxy. In one embodiment, the fibers (e.g., the distal endsof the fibers) can be held in a uniformly distributed fashion, forexample, with a tool during filling and hardening of the fillingmaterial; and, after the filler hardens, the ends may be cut and/orpolished.

With reference to FIG. 3, the filler of the fiberguide or waveguide 11is preferably optically transparent, comprising, for example, clearepoxy or glass. In certain ones of such embodiments, the fiberguide 11may include multiple beam-splitting mirror elements 17. The singlemirror elements 17 may comprise spherical structures, flat structures(such as glitter-type elements found in metallic paint), cubical orrectangular structures, crystalline structures (made of diamond,sapphire, or other materials), rods, prisms, or other shapes. In theillustrated embodiment, wherein the single mirror elements 17 comprisecubes coated with or formed of a reflective material, such as silver,aluminum or gold, light passing through the filler is reflected by thesingle mirror elements. The reflected light then interacts with othersingle mirror elements 17 in the filler, and also reflects (e.g., in adistal direction) off of a reflective coating on the boundary of thetapered filler. The reflective coating may comprise a silver, aluminumor gold coating, depending on wavelength as with the other reflectivematerials set forth herein. Regarding the single mirror elements, theirdiameters in one embodiment are within a range of from several times thewavelength of the electromagnetic energy to about 0.5 or 1 mm. Othersizes may be implemented in modified embodiments. In some embodiments,the single mirror elements are not formed of or coated with a reflectivematerial; for example, in one preferred embodiment, the single mirrorelements comprise balls, formed of sapphire. The single mirror elementscan be uniformly distributed, or in another embodiment approximatelyuniformly distributed or in another embodiment somewhat uniformlydistributed, in the filling material using known methods of suspendingparticles in for example a viscous medium such as electromagnetic wavesand/or shaking/spinning. In embodiments like that shown in FIG. 3, fiberoptic fibers may not be located in the fiberguide 11 since or to theextent the desired light emitting properties may be obtained by themirror elements 17.

In the embodiment of FIG. 4, the bundled fiberguide 11 comprises aplurality of hollow waveguides 19. The waveguides 19 may comprisesimilar materials as those used to form the fibers 16 described herein,or may comprise other materials. The waveguides 19 can comprise glass,plastic, metal, or other waveguide materials. In some embodiments, thewaveguides 19 can comprise hollow sapphire or nickel. In the illustratedembodiment, the waveguides 19 have cross-sectional areas and/ordiameters that increase in the distal direction. The cross-sectionalshapes may be rectangular or oval, for example. As presently embodied,the waveguides 19 can be formed by heating followed by deformation toattenuate the cross-sectional areas and/or diameters at the proximalends of the waveguides 19, while generating a tapered effect along thelengths of the waveguides 19. For example, the waveguides 19 may beheated and then pulled and/or compressed with a greater percentage ofthe pulling and/or compressing occurring near the proximal ends of thewaveguides. After the waveguides 19 have been shaped, their interiorsurfaces may be coated with reflective or semi-reflective materials,such as silver and germanium, aluminum, aluminum oxide, silver or gold.In the embodiment shown in FIG. 4, the bundled fiberguide 11 may or maynot include additional fiber optic fibers depending on the need of theuser of the apparatus.

The radiation emitting apparatus 10 can be housed in a handpiece, whichcan comprise an ergonomic design. An optional protective cap cover maybe attached to the handpiece or the radiation emitting apparatus 10. Thecap, which is preferably substantially transparent to the outputradiation, can be disposable and can comprise, for example, a snap-onconstruction to facilitate rapid attachment and removal thereof. The capcan further ensure clean surfaces of the applied parts. This cap, or inanother embodiment the handpiece itself, may have spacers or feet thatprovide a predetermined distance or spacing between the apparatus andthe target (e.g., teeth) surfaces to distribute the energy in apredetermined manner (e.g., at a certain concentration and/oruniformity). In one embodiment, the arched surface 14 can be spacedabout 1 mm from the teeth by the spacers.

A fiber optic cable 18 is coupled to the radiation emitting apparatus 10via the energy-distribution tuner 21. The fiber optic 18 can be made ofmaterials, such as sapphire, or other materials disclosed in U.S. Pat.No. 5,741,247, the entire contents of which are incorporated byreference herein to the extent compatible and/or not mutually exclusivewith the apparatus and methods of the present invention. Theenergy-distribution tuner 21 according to the invention couples thefiber optic 18 to the bundled fiberguide 11. The energy-distributiontuner 21 converts an energy distribution at its input into a differentenergy distribution at its output. In accordance with one aspect of thepresent invention, the energy-distribution tuner 21 comprises areflector, and in a particular embodiment the energy-distribution tunercomprises a cylindrical reflector. A longitudinal center axis of theenergy-distribution tuner 21, configured as a cylindrical reflector, canbe aligned with a longitudinal center axis of the fiber optic 18, asshown in FIG. 1. The energy-distribution tuner 21, configured as acylindrical reflector, can comprise, for example, an outer diameter ofabout 5 mm and a mirrored inner surface.

Although in the illustrated embodiment, the energy-distribution tuner 21comprises a reflective cylinder and the output end of the fiber optic 18is planar, other shapes of both devices can be incorporated in modifiedembodiments to achieve various spatial energy distributions at theoutput of the energy-distribution tuner 21. For example, the fiber opticoutput end may have spherical, conical, chiseled or otherlight-intensity altering (e.g., dispersing) shapes in modifiedembodiments.

In one embodiment the coupling of the fiber optic 18 cable to theenergy-distribution tuner 21 occurs within the handpiece of theradiation emitting apparatus 10, wherein the fiber optic 18 cable cancomprise either metal or a built-in metal tubing to attenuate anypossible fiber optic damage. The fiber optic itself 18 can comprise, forexample, a 600 um diameter quartz fiber, and can be disposed within thefiber optic cable whereby the fiber optic cable is fixed both at anelectromagnetic energy source side (not shown) and at the radiationemitting apparatus 10.

The energy-distribution tuner 21 can be constructed to emitelectromagnetic radiation in a nonconcentrically-focused manner,relative to its input which can be a cylindrically-shaped fiber opticend (i.e., a truncated fiber end). Output radiation from theenergy-distribution tuner 21 (and, also, from the radiation emittingapparatus 10) can be engineered to have a spatial energy distributionwhich differs from the spatial energy distribution of a conventionaltruncated fiber end. More particularly, in accordance with an aspect ofthe present invention, the energy-distribution tuner 21 (and, also, theradiation emitting apparatus 10) is constructed to generate outputradiation having a spatial energy distribution with one or more energyconcentrations or peaks located in areas other than a center of thespatial energy distribution. The center of the spatial energydistribution can be defined as an area aligned with (or intersecting) anoptical fiber axis of the apparatus or an area aligned with (orintersecting) an average direction of propagation of the outputradiation. According to one aspect, the center of the spatial energydistribution can be defined as a central part of a cross-section of theoutput radiation taken in a direction orthogonal to the direction ofpropagation of the output radiation.

With reference to FIG. 1 in particular, the energy-distribution tuner 21may be constructed to convert a “Gaussian” distribution of the laserradiation that is emitted from fiber optic 18 into a differentdistribution. At the output end 18 a of the fiber optic 18, light istypically emitted as a uniform circular spot having a maximal poweralong the center of an optical or longitudinal axis of the fiber optic18. An example of a power distribution for the output end 18 a is shownat 40. Toward the middle region 22 of the energy distribution tuner 21,the power distribution has a substantially “Gaussian” shape (as shown at42) with the width of the light beam being greater than at the outputend 18 a of fiber optic 18. The energy-distribution tuner 21 isconfigured to superimpose or mix direct beams with a hotter center(e.g., greater power) with reflected beams, which form a warm peripheralregion (e.g. less power than the center). The energy-distribution tuner21 is thus able to relatively uniformly distribute the light beams overa geometric shape, such as a circular shape, at a certain plane (e.g.,output surface 23).

The input end 13 of the fiberguide 11 is coupled to theenergy-distribution tuner 21 at that plane (e.g., output surface 23).Thus, in the exemplary illustrated embodiment of FIG. 1, the plane isdenoted by output surface 23. The power distribution at the outputsurface 23 is shown at 44. In the graph 44 of the power distribution atthe output surface 23 of the energy-distribution tuner, theaverage-uniform, high density radiation is shown at 44 a, the directlaser beams are shown at 44 b, and the reflected laser beams are shownat 44 c. Thus, the uniform distribution with a high power density isprojected from the output surface 23 to a uniform distribution at a lowpower density at surface 14, and as shown by the power distribution 46.

The output radiation in one embodiment has a spatial energy distributionwhich is relatively uniform across a geometric surface intersecting theoutput radiation. The geometric surface can be for example orthogonallydisposed relative to the output radiation. In the illustratedembodiment, the geometric surface is curved in the context of describingoutput radiation 12 from the radiation emitting apparatus 10 but isplanar in the context of describing output radiation from theenergy-distribution tuner 21. In other embodiments the geometric surfacecan be planar in the context of describing output radiation from theradiation emitting apparatus 10. A curved geometric surface canapproximate a curved surface of the treatment site, so that when thetreatment site is aligned with the curved geometric surface thetreatment site is irradiated uniformly with about the same energy at allof the points on the treatment site. The treatment-site can comprise,for example, a part of the body, such as a row of teeth, an elbow, awrist, or a portion of the jaw to be treated for temporomandibular joint(TMJ) disorders or conditions, wherein the curved geometrical surface isdesigned to follow the envelope of the anatomical area requiringtreatment.

In the illustrated embodiment, and as shown in FIG. 1, a uniform powerdistribution is generated over the area of a curved geometrical surface,such as the arched surface 14, which has a rectangular boundary of forexample about 33 mm by about 7 mm. In this embodiment, the outputradiation is applied uniformly within the rectangular boundary. Thetreatment site in the illustrated embodiment comprises the upper arch ofteeth in the mouth, whereby the curved geometric surface defining thelight emitting area of the apparatus is shaped as an arched rectangularsurface 14 to follow the anatomy of the upper arch of teeth. A variationon the design of the radiation emitting apparatus 10 may be soconfigured that it can direct electromagnetic energy on the front, backor occlusal surfaces of the target surface (e.g., teeth). The radiationemitting apparatus 10 may also be used, for example, for whiteningteeth, bio-stimulation, caries prevention, caries detection (incombination with filtered eyeglasses to visualize and detect emittedfluorescent light), desensitizing teeth, and composite curing(restorations, laminates, brackets for braces).

Electromagnetic energy can be supplied at wavelengths from about 0.4 μmto about 11 μm, and in certain embodiments from about 0.4 μm to about 3μm, from a light source such as a plasma arc lamp, a LED, or a laserhaving a continuous wave (CW) or pulsed mode of operation. In anexemplary embodiment, the electromagnetic energy is laser radiation froma semiconductor diode laser source, delivering up to 10 W CW at an815+/−10 nm wavelength. In one exemplary embodiment, for a rectangulararea of 33 mm by 7 mm, the output energy density can be about 3 to 4W/cm². In another embodiment, the electromagnetic energy is non-coherentlight from a zenon arc lamp with an output energy density of about 1W/cm² across a rectangular area of 33 mm by 7 mm, and this output can beapplied continuously to a target, such as teeth, for 10 to 40 seconds.The output area may be larger or smaller, and in one embodiment theoutput area of the bundled fiberguide 11 may have a maximum dimensionof, for example, about 8 to 12 mm.

As presently embodied, the radiation emitting apparatus 10 can comprisea relatively short length, measured in a direction normal to the target.More particularly, as presently embodied the length, measured in adirection normal to the target, can be about 35 mm between the distalend of the bundled fiberguide 11 and the proximal end of theenergy-distribution tuner 21. In accordance with an aspect of thepresent invention, the energy-distribution tuner 21 is formed so as,when combined with the bundled waveguide 11, to provide a desirabledistribution of power (e.g., a relatively uniform power density) acrossthe topography of a predetermined treatment site (e.g., a surfacetopography corresponding to the arched surface 14). In otherembodiments, energy-distribution tuners 21 can be combined with bundledfiberguides 11 to generate distributions of energy on a curvedgeometrical surface in the form of, for example, one or more of anoutline or ring shape, a gradual transition, or a uniform distribution.

The diameter and construction of the fiber optic 18, and the positionand orientation of the fiber optic 18 adjacent to or inside theenergy-distribution tuner 21, may be interdependent and in theillustrated example can be selected to provide a desired (e.g., veryuniform) distribution of radiation power over the output surface 23 ofthe energy-distribution tuner 21. By uniform distribution, it is meantthat an energy density (or power density) on a predetermined area (e.g.,3 mm²) of the geometrical surface (e.g., output surface 23 or archedsurface 14) is within plus or minus about 5% of the average energy orpower density of the geometrical surface (i.e., illuminated area). Inanother embodiment, the power density of a predetermined area of thegeometrical surface can be within plus or minus about 50% of the totalaverage power density of the geometrical surface. In a modifiedembodiment, uniform distribution can mean that an energy density (orpower density) on a predetermined area of the geometrical surface iswithin plus or minus about 5% of that of an adjacent area of the samesize. In contrast, the variance between a power density of a centralarea of a prior-art truncated fiber end can be 200 to 1000% greater thanthe average power density of the total illuminated area.

The radiation emitting apparatus 10 may be used with a gel for whiteningteeth, caries prevention, caries detection, and desensitizing teeth. Thegel can comprise one or more of the following: (a) A target chromophorethat could be a pigment, dye or chemical compound (Ultramarine Violet,Ultramarine Blue, ‘4301 Black’, Caramel, or Black oxide), stronglyabsorbed by laser wavelengths in the infrared from 700 nm to 3 microns.(b) Furthermore, organic and inorganic pigments and dyes, and otherfood, drug and cosmetic color additives, which include, but are notlimited to, the following: Complex inorganic odor pigments for shades ofblack, brown, red, yellow, green, blue and violet; Beta Carotene(orange/yellow); Riboflavin (orange/yellow); Iron oxides (black, brown,yellow and red); Ultramarines (green, blue, violet and red); Chromiumoxide green; grape skin extract; dehydrated beets; and annalto extract(orange), can be implemented for activation by visible or infraredwavelengths. (c) Another type of additives are Epolight dyes for laserprotective eyewear, which are disclosed in U.S. Provisional ApplicationNo. 60/314,858 and incorporated herein by reference to the extentcompatible and/or not mutually exclusive with the apparatus and methodsof the present invention, and which can be implemented with the gelbecause of their specific selective absorption at the specific laserwavelength. (d) Agents to increase activation of the whitening substancesuch as metal powders (i.e. copper, bronze powder). (e) A whiteningsubstance (including, but not limited to hydrogen peroxide or Carbamideperoxide) is capable of breaking down and removing stains in targetmaterial when activated by laser/EM energy directly, or via targetchromophore absorption. (f) Substances for preventing or prohibitingcaries development, such as Calcium fluoride, Amine fluoride, Sodiumfluoride, Sodium monofluorophosphate, and Stannous fluoride are alsoconsidered as additives to the gel. The fluoride compound may also beused together with antibacterial agents capable of killing Streptococcussangius, Streptococcus mutans, Actinomyces viscosus, and other bacteriaassociated with tooth caries. These agents may include benzol-koniumchloride, phenol, stannous fluoride, sodium phenolate, sodium laurylsulfate, sodium N-lauroyl sarcosinate, or sodium cocomonoglyceridesulfonate. (g) Another substance, Potassium nitrate, can be added to thegel for desensitizing effects on teeth.

The whitening substance could be hydrogen peroxide, carbamide peroxideor some other whitening substance, which could comprise up to 50% of thewhitening gel. The pigment concentration can comprise up to 50% of thegel composition. In more specific embodiments, it comprises between0.01% and 15% of the gel composition.

The following steps describe the method of using the whitening gel withthe handpiece to whiten human teeth: (a) apply a layer of gel over theteeth surfaces; (b) place the handpiece above the gel-covered surfaces,on the upper or lower arch of the mouth; (c) activate the laser for theprescribed time duration; (d) wait for a predetermined period of timeand activate the laser again if necessary.

In one embodiment, the laser is activated for 1-10 seconds. In anotherembodiment, the laser is activated for 10-30 seconds. In anotherembodiment, the laser is activated for 30-60 seconds. Laser activationtimes of over one minute could be applied depending on the type of stainand power density setting. The waiting period between exposures may befrom 0 seconds to 15 minutes in one embodiment, or between 15 and 30minutes in another embodiment. The laser power density may be, althoughnot limited to, in the range of 0 W/cm²-50 W/cm². In one embodiment, thepower density is around 3 W/cm². An example of a full-mouth procedurecan be performed by following these steps:

1) Divide the upper and lower arches of teeth into four quadrants, witheach quadrant having up to 4 teeth or more.

2) Apply whitening gel to the teeth to be treated.

2.1) Direct the whitening handpiece toward the first quadrant, using alaser power density of 3 W/cm².

2.2) Activate the laser for 15 seconds, and then stop.

2.3) Repeat the same procedure for the second, third and fourthquadrants.

2.4) Wait for a period of 1 minute and repeat steps 2.1-2.4 a furtherthree to ten times depending on the condition of the patient's teeth.

2.5) Remove the whitening gel from the teeth.

3) Repeat the treatment steps up to two more times depending on thenature of the patient's stain.

The above is just one example of a tooth whitening method using thewhitening gel and handpiece. The time of exposure and number ofapplications can vary depending on the patient, and thus the inventionis not limited to the example procedure described above.

Laser energy in medicine is usually used as a surgical tool to removetissue. Low Level Laser Therapy (LLLT) uses laser energy at power levelsbelow those required to cut or ablate tissue, to nonthermally andnondestructively alter cellular function.

Nerve tissue, according to the literature, has a photosensitivecomponent which reacts to laser exposure, reducing the excitability ofthe nerve cells by interrupting the fast pain fibers with a resultantreduction in pain. LLLT has also been shown to accelerate the repairprocess of crush-damaged nerves and improve function in both the CNS andperipheral nerves after injury.

The proposed delivery handpiece can be used to treat a number ofsymptoms and conditions, including: (a) pain reduction when directed atacupuncture points and muscular trigger points and when used to treatchronic tendinopathies, degenerative arthritis, rheumatoid arthritis,muscle pain, tendonitis. tension myalgia, chronic radiculopathy, chronicneuropathy, acute soft tissue pain; also a reduction in tissue swelling,bruising and TMJ disorders or conditions. (b) treatment of myofacial andpostoperative pain; muscle tears; hematomas; tendonitis; shingles;herpes simplex; scarring; burn and wound healing

According to this invention, the handpiece is designed in a shape andsize broadly corresponding to the area to be treated, and will evenlydistribute the energy over the target area. The electromagneticwavelength for this device can be between 0.4-11 nm. Typical poweroutput levels for a treatment can range from 10-700 mW, morespecifically 15-100 mW. Energy levels can range from 0-8 J/cm², morespecifically 0-4 J/cm². Treatment time can be between 10 seconds to 10minutes, and more specifically 10 seconds to 4 minutes. Repeatedtreatments may be required on the same day and at different timeintervals, or at different dates.

In a procedure utilizing this device, the clinician will point thehandpiece toward either the tissue site requiring treatment, acupuncturepoints, or muscle trigger points, and then direct laser energy towardthe target for a given period of time.

The above-described embodiments have been provided by way of example,and the present invention is not limited to these examples. Multiplevariations and modification to the disclosed embodiments will occur, tothe extent not mutually exclusive, to those skilled in the art uponconsideration of the foregoing description. Additionally, othercombinations, omissions, substitutions and modifications will beapparent to the skilled artisan in view of the disclosure herein.Accordingly, the present invention is not intended to be limited by thedisclosed embodiments, but is to be defined by reference to the appendedclaims.

1. A radiation emitting apparatus, comprising: a fiber optic end; anenergy-distribution tuner coupled to the fiber optic end; and a bundledfiberguide or waveguide coupled to the energy-distribution tuner havinga width that increases in a distal direction and being constructed todirect energy emitted from the energy-distribution tuner in thedirection away from the radiation emitting apparatus and toward atreatment site.
 2. The radiation emitting apparatus as set forth inclaim 1, wherein the energy-distribution tuner comprises a cylindricalreflector.
 3. The radiation emitting apparatus as set forth in claim 1,wherein the bundled fiberguide or waveguide comprises a coherent taperedfused fiber.
 4. The radiation emitting apparatus as set forth in claim1, wherein: the energy-distribution tuner comprises a cylindricalreflector; and the fiber optic end is centered to emit energy throughthe cylindrical reflector.
 5. The radiation emitting apparatus as setforth in claim 4, wherein a longitudinal center axis of the cylindricalreflector is aligned with a longitudinal center axis of the fiber opticend.
 6. The radiation emitting apparatus as set forth in claim 5,wherein the radiation emitting apparatus is disposed within a handpiece.7. The radiation emitting apparatus as set forth in claim 1, wherein thebundled fiberguide or waveguide is coupled to the energy-distributiontuner to receive a uniform distribution of high power energy therefrom,and is configured to emit a substantially uniform distribution of energyhaving a lower power than received from the energy distribution tuner.8. The radiation emitting apparatus as set forth in claim 1, wherein thebundled fiberguide or waveguide is configured to emit a substantiallyuniform distribution of energy from an irregularly shaped output end. 9.The radiation emitting apparatus as set forth in claim 8, wherein theirregularly shaped output end includes a curved surface having anon-circular cross-section.
 10. The radiation emitting apparatus as setforth in claim 1, wherein the bundled fiberguide or waveguide includes aplurality of fused optic fibers.
 11. The radiation emitting apparatus asset forth in claim 1, wherein the bundled fiberguide or waveguideincludes a plurality of beam-splitting mirror elements.
 12. Theradiation emitting apparatus as set forth in claim 1, wherein thebundled fiberguide or waveguide includes a plurality of taperedwaveguides.
 13. The radiation emitting apparatus as set forth in claim1, wherein the bundled fiberguide or waveguide includes an elongate bodywith a first end having a first cross-sectional area and a second endhaving a second cross-sectional area that is different than the firstcross-sectional area, the second end including a curved surface foremitting energy received from the energy distribution tuner toward atarget surface.
 14. A method of exposing a target surface to radiationusing the apparatus of claim 1, comprising: reflecting radiation in anenergy distributor to generate a substantially uniform distribution ofthe radiation at an output surface of the energy distributor, thesubstantially uniformly distributed radiation having a first power; anddirecting the substantially uniformly distributed radiation through abundled fiberguide or waveguide to form a substantially uniformdistribution of radiation having a second power that is substantiallyless than the first power whereby the substantially uniform distributionof radiation having the second power is directed toward a targetsurface.
 15. The method as set forth in claim 14, wherein the energydistributor is an energy distribution tuner.
 16. The method as set forthin claim 14, wherein the reflecting is preceded by directing radiationfrom a fiber optic end toward the energy distribution tuner.
 17. Themethod as set forth in claim 14, wherein the radiation is directedtoward a surface of a patient.
 18. The method as set forth in claim 14,wherein the radiation is directed toward a dental surface of a patient.19. A radiation emitting apparatus, comprising: an energy distributor;and a bundled fiberguide or waveguide including an elongate body with afirst part having a first cross-sectional area, and a second part havinga distally disposed second cross-sectional area that is greater than thefirst cross-sectional area, the second part including a curved surfacefor emitting energy received from the energy distributor toward a targetsurface.
 20. The radiation emitting apparatus as set forth in claim 19,wherein the bundled fiberguide or waveguide includes a tapered elongatebody.
 21. The radiation emitting apparatus as set forth in claim 19,wherein the first end of the elongate body is coupled to the energydistributor.
 22. The radiation emitting apparatus as set forth in claim19, wherein the bundled fiberguide or waveguide includes an energydirecting member selected from the group consisting of fused opticalfibers, beam splitting mirror elements, and tapered waveguides.
 23. Theradiation emitting apparatus as set forth in claim 19, wherein thecurved surface has a substantially rectangular cross-sectionalconfiguration.
 24. The radiation emitting apparatus as set forth inclaim 19, wherein: the radiation emitting apparatus further comprises anend of a quartz fiber; the energy distributor is a cylindricalreflector; and the bundled fiberguide or waveguide includes a reflectiveinterior surface.
 25. The radiation emitting apparatus as set forth inclaim 19, wherein the energy distributor is an energy distributiontuner.
 26. A radiation emitting apparatus, comprising: a fiber opticend; an energy-distribution tuner coupled to the fiber optic end; and abundled fiberguide or waveguide coupled to the energy-distribution tunerand being constructed to direct energy emitted from theenergy-distribution tuner in a direction away from the radiationemitting apparatus and toward a treatment site, wherein the bundledfiberguide or waveguide includes a plurality of beam-splitting mirrorelements.